Workers Compensation Board of Prince Edward Island

Managing Your Claim

The WCB understands that having a workplace injury or illness can be confusing and stressful. We want to make sure you have the information you need, so that working with us is a straightforward and positive experience.

This section of our website explains the WCB claim process, your responsibilities and what you can expect during the duration of your claim. You will also find a number of resources to help you understand your condition and the recovery process.
More information about managing your claim can be found in Information for Workers booklet, and our claims policies.

If you can't find what you are looking for, or if you have any questions about your claim, please contact us.

The WCB Claim Process

A claim with the WCB begins with adjudication. Adjudication is the decision-making process to consider whether a claim can be accepted.

To adjudicate your claim, the WCB requires:
  • A Worker's Report - Form 6 from you.
  • A Employer's Report - Form 7 from your employer.
  • A Physician's Report- Form 8, from your doctor or chiropractor.
When a report is filed, the WCB registers your claim and assigns it to an entitlement officer. If more information is required to make a decision or if some information is missing, the entitlement officer will contact you, your doctor and/or your employer.

Once the required information is gathered, the entitlement officer will make a decision on your claim. If your claim is accepted you may be eligible for benefits and services, and the return to work process may begin.

If your claim is not accepted you will be advised in writing. You may discuss the decision with the entitlement officer if you have any questions or concerns. Please note that you have the right to request a reconsideration of the decision within 90 days from the date of notification.

Benefits will begin when your claim is accepted by the WCB. Under certain circumstances, treatments such as physiotherapy or chiropractic services may be approved earlier, if the WCB has received your Worker's Report.

If your injury causes you to lose time from work for more than four weeks, your claim will be transferred to the WCB case management team. This team is made up of Case Coordinators, Occupational Therapists and Vocational Rehabilitation Counselors who will assist you throughout your medical recovery and your return to work.
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Roles and Responsibilities

As a worker, you are responsible for taking reasonable steps to assist in your recovery and return to work. This includes:
  • Contacting your employer as soon as possible after the injury occurs and maintaining weekly contact throughout your recovery.
  • Cooperating with your employer and the WCB in the timely and safe return to work process.
  • Taking an active role in your recovery by,
    • following the prescribed treatment,
    • attending scheduled appointments, and
    • asking questions if there is something you don't understand.
  • Please note that participation in your treatment plan is essential to your recovery. If you miss treatments or appointments you may delay your recovery and risk suspension of your benefits.
  • Keeping your WCB case worker informed of any changes in your medical condition or income, including confirmation of a return to work date. If you are not sure whether a change should be reported, ask your case worker.
  • Maintaining weekly contact with the WCB Occupational Therapist, if one is involved in your recovery.
From the WCB, you can expect:
  • To be treated with fairness, care and respect.
  • Open and honest communication.
  • Professionalism and integrity.
  • Your Entitlement Officer or Case Coordinator to assist you toward a successful recovery and return to work by:
    • Assisting you with your claim.
    • Answering questions about your treatments and conditions.
    • Acting as a contact with your health care providers and your employer.
    • Coordinating resources to support you and your family during your recovery and return to work.
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If you can't find what you are looking for, or if you have any questions about your claim, please contact us.

In order to serve you better, please have the following on hand when contacting the WCB:
  • Your date of injury (or the date you first noticed symptoms).
  • Entitlement Officer or Case Coordinator's name and phone number.
  • Your case ID number.